The Da Vinci Robot, a Promising Yet Underused Minimally Invasive Tool for Spine Surgery: a Scoping Review of its Current Role and Limits.

Background: The Da Vinci robot ® (DVR), released in the early 2000s, provided a set of innovation aiming at pushing minimally invasive surgery forward. Its stereoscopic magnified visualization camera, motions that exceed the natural range of the human hand, or tremor reduction enhanced the surgeon's skills and added value in many surgical fields.

Objective: To map the current use of the DVR in spine surgery, identify gaps, address its limits and future perspectives.

Methods: We conducted a scoping review upon PRISMA guidelines through Pubmed from inception to July 2024, including english-written articles describing clinical use of the DVR on procedures related to spinal conditions. We collected a broad range of data, from journals publishing those articles, to the study design, the purpose of the study, the sample size or conclusions. We then provided a narrative review on the scope of indications and results of those studies.

Results: Seventeen studies including a total of forty-nine patients were included. Those included procedures in the craniocervical junction for 4 patients, thoracic spine for 5 cases, 29 patients involved the lumbar and lumbosacral segment, and 11 on the sacral region. Pathologies included degenerative diseases with 25 cases (14 ALIF and 11 OLIF), tumors as paraspinal schwannomas and odontoid lesions, but also basilar invagination of the odontoid process, Tarlov cyst, and sacral fracture.

Conclusion: The DVR presents as a valuable tool for minimally invasive surgery in selected cases. Further studies including cost effectiveness, leaning curve, and control trial are needed.